Amerigroup/Amerivantage
Part D prescription drugs covered by Amerivantage are listed in the Amerigroup five-tier formulary. The formulary includes all generic drugs covered under the Part D program, as well as many brand-name drugs, nonpreferred brands and specialty drugs. A copy of the formulary on the Amerigroup website at https://providers.Amerigroup.com. From the Provider Resources and Documents library, select Pharmacy Tools, then Medicare Formulary or request a copy from the Provider Relations department. Some of these drugs have precertification or step-therapy requirements or quantity limits. Providers may request authorization for a drug or coverage of a drug not on the formulary by contacting the Amerigroup Provider Services at 1-866-805-4589. Members should obtain Part D covered drugs from a network pharmacy pursuant to a physician’s prescription.

Please refer to the formulary when prescribing for Amerigroup members. Though most medications on the formulary are covered without Prior Authorization (PA), a few agents will require you to obtain an authorization.

For Amerivantage Part B, please call 281-591-5289, Option 1, from 8 a.m. to 8 p.m. local time, Monday through Friday. For Amerivantage Part D, contact Express Scripts Provider Services at 1-800-338-6180, 24 hours a day, 7 days a week.